IntroductionPediatric growth hormone deficiency (GHD) is a disease resulting from impaired growth hormone/insulin-like growth factor-1 (IGF-1) axis but the effects of GHD on children’s cognitive function, brain structure and brain function were not yet fully illustrated.MethodsFull Wechsler Intelligence Scales for Children, structural imaging, diffusion tensor imaging, and resting-state functional magnetic resonance imaging were assessed in 11 children with GHD and 10 matched healthy controls.Results(1) The GHD group showed moderate cognitive impairment, and a positive correlation existed between IGF-1 levels and cognitive indices. (2) Mean diffusivity was significantly increased in both corticospinal tracts in GHD group. (3) There were significant positive correlations between IGF-1 levels and volume metrics of left thalamus, left pallidum and right putamen but a negative correlation between IGF-1 levels and cortical thickness of the occipital lobe. And IGF-1 levels negatively correlated with fractional anisotropy in the superior longitudinal fasciculus and right corticospinal tract. (4) Regional homogeneity (ReHo) in the left hippocampus/parahippocampal gyrus was negatively correlated with IGF-1 levels; the amplitude of low-frequency fluctuation (ALFF) and ReHo in the paracentral lobe, postcentral gyrus and precentral gyrus were also negatively correlated with IGF-1 levels, in which region ALFF fully mediates the effect of IGF-1 on working memory index.ConclusionMultiple subcortical, cortical structures, and regional neural activities might be influenced by serum IGF-1 levels. Thereinto, ALFF in the paracentral lobe, postcentral gyrus and precentral gyrus fully mediates the effect of IGF-1 on the working memory index.

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与儿童生长激素缺乏相关的大脑结构和功能的改变：多模态磁共振成像研究

IntroductionPediatric growth hormone deficiency (GHD) 是一种由生长激素/胰岛素样生长因子-1 (IGF-1) 轴受损引起的疾病，但 GHD 对儿童认知功能、大脑结构和大脑功能的影响尚未得到充分说明。方法对11例GHD患儿和10例匹配的健康对照者进行全韦克斯勒儿童智力量表、结构成像、弥散张量成像和静息态功能磁共振成像评估。 IGF-1水平与认知指标之间存在相关性。(2) GHD组皮质脊髓束的平均扩散率显着增加。(3) IGF-1水平与左侧丘脑体积指标呈显着正相关，左侧苍白球和右侧壳核，但 IGF-1 水平与枕叶皮质厚度呈负相关。IGF-1 水平与上纵束和右侧皮质脊髓束的部分各向异性呈负相关。(4)左侧海马/海马旁回区域同质性(ReHo)与IGF-1水平呈负相关；中央旁叶、中央后回和中央前回的低频波动幅度（ALFF）和ReHo也与IGF-1水平呈负相关，其中ALFF完全介导了IGF-1对工作记忆指数的影响。皮质下、皮质结构和局部神经活动可能受血清 IGF-1 水平的影响。其中，中央旁叶的 ALFF，